March 6, 2023According to research published in The, neurofeedback may not work for ADHD treatment in boys. American Journal of Psychiatry The study examined whether functional MRI neurofeedback was a safe and effective alternative for pharmacological ADHD treatment. Subjects who received fMRINF in this double-blind, randomized controlled trial did not experience significant improvement in their ADHD symptoms or cognitive abilities. 1
Is Neurofeedback Effective?
ADHD patients have impaired brain function in the frontal cortex, which is responsible for executive function, attention, and organization. Researchers conducted a new study to determine if neurofeedback training could activate the right inferior cortex (rIFC). The first-line treatment is medication. However, not all patients receive medication. 2 Side effects are also common.
Researchers wrote that functional MRI neurofeedback could be a new alternative to pharmacological treatments. It allows brain activation to be self-regulated in certain regions or networks, and provides feedback on brain activity in real-time.
Each run featured a video of a rocketeer in space. Rocketeer (up/down) is a visual representation of the direction and speed of each run. In the sham group, neurofeedback was provided by the participant who had been active in place of that person’s own.
The active fMRINF groups showed significantly more activation of the rIFC than did the sham control group. The primary outcome measurement for the researchers was ADHDRS. They found that there were no improvements in ADHDRS scores. The study hypothesis was not met. The parents of children treated with fMRI-NF did not notice any improvements in their child’s ADHD symptoms.
In the post-treatment assessment, the sham group had a lower level of motor inhibition and irritability than the others. Researchers did not observe a progressive upregulation in subjects who received fMRI-NF. They also observed no correlations between changes made in rIFC activation scores and ADHD-RS scores. There was also no transfer of learning.
The researchers stated that the findings did not support the idea that fMRINF of rIFC was an effective treatment for ADHD.
Editorial research by Parents also reported that neurofeedback was ineffective in addressing ADHD symptoms. A 2017 survey of 2,495 caregivers found that less than one-third of those who tried NF found it effective. They rated it less efficacious than medication, ADHD coaching, counseling, exercise, medication, and behavioral therapy, but more effective than mindfulness meditation, nutrition changes, and better than ADHD coaching or counseling in addressing ADHD symptoms.
The high cost of treatment was cited by caregivers as a reason for the low adoption rate of neurofeedback. 29% of caregivers stated that they have not tried non-medication ADHD treatment options due to lack of or price.
New Study Limitations
Between 2018 and 2020, researchers used clinical, cognitive, fMRI, and other measures to assess seven participant visits. This included baseline assessments, fMRI interventions and post-treatment assessment. Follow up was six months. Researchers did not have direct contact with participants, but were blinded to administer treatment.
This double-blind study was an extension of a proof-of-concept single-blind study that was conducted in 2017.The small sample size of study was small and had no control group. The new research was constrained by the inclusion of an all-male participant group, aged between 10 and 18, with approximately 65% of them being active medication users. Due to COVID lockdowns, the study was terminated prematurely.
Future studies should examine whether fMRINF of other regions of interest or networks involved in ADHD might be more effective in improving clinical, cognitive and other problems.”
However, the results were effective in informing parents/clinicians of the best treatment options available for children with ADHD.
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